Which extraintestinal manifestations (EIMs) are the most common in adults and children with Crohn disease?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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EIMs may carry prognostic importance in Crohn disease.

Musculoskeletal disease

Musculoskeletal pain is considered the most common EIM of adult IBD, occurring in 9-53% of affected patients. [50, 51, 52] The differential diagnosis of this condition is vast and includes IBD-associated arthritides such as arthralgia (5-20%), ankylosing spondylitis (1-26%), psoriatic arthritis, reactive arthritis, and sacroiliitis, as well as fibromyalgia and osteoporosis and osteoporosis-related fractures.

The most common EIM in children and adolescents is arthritis (7-25% of pediatric patients), which may occur years before any GI symptoms develop and may persist after surgical or medical remission of the disease. The arthritis is usually seronegative, transient, and nondeforming; has an asymmetric distribution; and involves the large joints of the lower extremities.

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